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Biomedical subjects

L Greiner

Publications and source records attributed to L Greiner.

At least 73 records · Page 4Linked to original sources
PubMed1985

[Puncture-sonographic alcohol neurolysis of the celiac plexus. A new technic for the therapy of severe chronic upper abdominal pain].

Coeliac plexus nerve block by alcohol through a percutaneously introduced, ultrasonically guided, small needle was performed in 36 patients with severe chronic upper-abdominal pains, 32 of them with malignant and four with benign disease. In 11 patients there was lasting, in eight transitory freedom from the pain, while in five other patients there was a definite diminution of pain, and the use of analgesics and especially opiates was discontinued or at least markedly reduced. Body-weight increased in 14 patients. In a woman with chronic pancreatic pain who had several previous operations alcohol injection triggered off an acute attack of pancreatitis which ended fatally.

Abdomen↗
PubMed1985

[Accuracy of ultrasound-guided fine needle biopsy in pancreas cancer--effect of puncture frequency and character of puncture material].

There is no agreement upon the number of punctions guided by ultrasonography needed to establish cytologically the diagnosis of pancreas carcinoma. Therefore reliability of the method as being dependent upon the number of punctions in 43 maligne tumors of the pancreas was evaluated. Performing two to five punctions yielded significantly better results than just one. In addition the macroscopic aspect of the aspirate is important.

Biopsy, Needle↗
PubMed1984

[Ranitidine and cimetidine in the prevention of stress: ulcer hemorrhage a prospective comparative multicenter study].

In a multicentre single-blind study, ranitidine was compared to cimetidine as prophylactic treatment against stress-induced upper gastrointestinal bleeding in seriously ill patients in the intensive care unit (ICU). 380 patients entered the study. 192 patients were treated with ranitidine 50 mg q.i.d. as i.v. bolus followed by 150 mg orally twice daily. 188 patients received cimetidine 400 mg q.i.d. intravenously and 1,000 mg daily orally in divided doses. Five patients in the ranitidine group (2.6%) and 12 in the cimetidine group (6.4%) developed gastrointestinal bleeding definitely or possibly due to stress lesions. This difference was not significant. The incidence of stress erosions or ulcerations developing during the study was 11.8% for the ranitidine group and 18.3% for the cimetidine group (non-significant difference). Adverse events in the ranitidine group were nausea, tachycardia or vomiting in 4 patients. 5 cimetidine-treated patients developed cholestasis, and 5 additional central nervous system problems. The high degree of efficacy of both drugs compared very favourably with the high incidence of stress ulceration and hemorrhage in similar untreated populations.

Adolescent↗
PubMed1984

[Failure of puncture sonographic diagnosis of focal liver lesions--the influence of possible sources of error].

A correct diagnosis was obtained in 92 cases (87.6%) of 105 sonographically monitored fine-needle punctures of focal lesions of the liver; in 13 cases (12.4%) the diagnosis was wrong. Both groups were compared with each other in respect of the anatomic and sonographic properties of the puncture targets and the technique of biopsy employed. Reflexibility and definability of the lesions did not influence the number of wrong diagnoses in puncture sonography; likewise, the following factors did not affect the quota of errors: the macroscopic structure of the punctate; the outer diameter of the fine needle; and the fact whether puncture was effected by means of a special biopsy sound head or by free-hand technique. Limited influence was exercised by the size and depth position of the intrahepatic space-occupying growths and by the number of punctures.

Biopsy, Needle↗
PubMed1984

[Stomach neurinoma].

Between 10 and 15% of all benign nonepithelial tumors of the stomach are neurinoma. The majority of these tumors originating from the plexus myentericus do not cause clinical symptoms. They become clinically important because of complications like hemorrhage, perforation or displacement of neighbouring organs. Typical clinical symptoms, laboratory data, radiological or endoscopic findings do not exist. The diagnosis neurinoma can only be established by histological examination; differentiation of myogenic tumors is often difficult. The surgical procedure has to take into account extension, localisation, and relation of the tumor to the stomach wall. If multiple neurinoma extending from the cardia to the pylorus are present total gastrectomy may be necessary.

Adult↗
PubMed1984

[Solitary liver abscesses in chronic brucellosis].

In two patients from southern Italy, the sonographic finding of great solitary focal liver lesions was contributed to brucella-abscesses (brucelloma) according to the clinical and serological data and to the results of ultrasonically guided fine needle aspiration biopsies. In both cases, laparotomy confirmed the diagnosis. We discuss the clinical findings and differential diagnosis of this uncommon inflammatory focal liver lesion.

Adult↗
PubMed1983

[Sonographically assisted liver biopsy--replacement for blind needle biopsy?].

Since the beginning of 1980 the authors have performed upper-abdominal ultrasound examination immediately preceding percutaneous needle biopsy (after Menghini), previously performed "blind". Knowledge of the particular liver topography made it possible to perform reliably punctures with only a small number of multiple punctures (6.4%) being required, suitable biopsies more often being obtained than under laporoscopic control. Compared with 354 consecutive blind liver biopsies, guided biopsy caused pain from the puncture in 1.9% (previously 5.9%), with a reduction of need for analgesics from 4.5% to 1.1%. The rate of more serious complications was reduced from five (1.4%) to one (0.2%), although as a result of ultrasound the indications for percutaneous liver biopsy were more frequent, since numerous "classical" contra-indications could be ignored. Blind liver biopsy should thus be abandoned for ultrasound-guided percutaneous puncture.

Adolescent↗
PubMed1983

[Sonographically guided and intraoperative alcohol block of the celiac ganglia in conservatively uncontrollable cancer-induced epigastric pain].

Preliminary results of sonographically controlled alcohol injection into the region of the coeliacal ganglion for treatment of medically intractable pain in inoperable pancreas carcinoma (6 patients) are compared with results of a similar treatment using a surgical approach (10 patients). Both procedures resulted in up to total pain relief and marked reduction of consumption of analgetics. Neurolysis of the coeliacal ganglion by means of sonographically guided alcohol injection seems to be a useful treatment to reduce pain in inoperable pancreas carcinoma.

Biopsy, Needle↗
PubMed1983

Pancreatico-pleural fistula with chronic pleural effusion--endoscopic-retrograde visualization and therapy by ultrasonically--guided drainage.

In a patient with alcohol-induced chronic pancreatitis, a large chronic left-sided pleural effusion persisted after partial pancreatectomy (resection of the pancreatic tail). ERCP outlined a transdiaphragmatic fistula between the duct of the remaining pancreas and the pleural cavity. The effusion was removed by ultrasound-assisted thoracocentesis, and the fistulous canal was obliterated permanently.

Adult↗
PubMed1983

[Coincidence of chronic pancreatitis and liver cirrhosis in alcohol abuse. A x-ray and histomorphological study].

We conducted a retrospective study in 112 chronic alcoholics in order to evaluate the incidence of simultaneous damage of both pancreas and liver. In all patients, an endoscopic retrograde pancreaticography (ERP) and a liver biopsy were performed. 65 patients had alterations of the pancreatic ducts compatible with the diagnosis of chronic pancreatitis. 30,7% (20/65) suffered from an additional alcoholic liver cirrhosis. This is a much more frequent association than presumed by H. Sarles et al. and Ammann et al. When the diagnosis was established, the average age of the group with chronic pancreatitis and liver cirrhosis was the same as in patients with chronic pancreatitis without cirrhosis (43,3 versus 42,4 years). Routine laboratory findings were of little value in comparison to the morphological findings.

Adult↗
PubMed1983

[Sonographic follow-up of endoscopic papillotomy, percutaneous transhepatic drainage and endoscopically implanted bile duct prosthesis].

Normal transpapillary bile flow after EPT with or without implantation of bile duct draining catheters can be checked by sonographic demonstration of air in the bile ducts and/or normal calibers of the bile duct system. The position of percutaneous transhepatic catheters within the liver can be shown by sonography after insufflation of air into the catheter in most cases; this will allow to ascertain the correct location in the bile duct system or the dislocation of the catheter into the abdominal cavity. After EPT, PTD or endoscopic implantation of bile duct draining catheters sonography should be the first line procedure in controlling the success of the intervention before x-ray examination or endoscopy are applied.

Ampulla of Vater↗
PubMed1983

[Colitis in the non-functioning rectosigmoid after establishment of an end-sigmoid colostomy].

In 11 patients with a sigmoid end colostomy (and one additional patient with an end ileostomy), we examined the endoscopic and microscopic aspects of both the dysfunctioned bowel and the colon proximal to the colostomy. The latter showed in none of the cases signs of inflammation, while in 7 patients a remarkable or even severe colitis (mimicking ulcerative colitis) could be demonstrated endoscopically and/or histologically - irrespective to the duration of the dysfunction (one month up til 11 years). In the four patients with restoration of the intestinal continuity, macroscopic and microscopic findings of the rectal mucosa became normal as soon as two weeks after reoperation. We conclude, that the "dysfunctioned bowel-colitis" is somehow related to the mucosa's contact to the fecal stream.

Aged↗
PubMed1981

[Nodular lymphoid hyperplasia of the small intestinal, hypogammaglobulinemia and rheumatoid arthritis (author's transl)].

A case report is given of a patient with intestinal nodular lymphoid hyperplasia, hypoimmunoglobulinemia and seronegative rheumatoid arthritis with extensive deformation of joints, who was diagnosed and followed for 10 years clinically and by repeated endoscopic and bioptic examinations. It could be shown for the first time by temporary omission of corticosteroids that continuous therapy with corticosteroids is indispensable in this disease.

Adrenal Cortex Hormones↗